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Byline: Girish. Rajadhyaksha, Ameena. Meah Background and Aims: In a medical intensive care unit (MICU), many patients develop hemostatic abnormalities, ranging from abnormal clotting tests to frank bleeding. The aim [...]

The Buteyko Breathing Technique (BBT) has been found to be effective in the treatment of Asthma, Obstructive Airway Disease and other diseases. Its effect on Hypertension has not been studied. Aim and Objectives: To study the effect of Buteyko Breathing technique for 4 weeks on Hemodynamic parameters and functional capacity in subjects with primary hypertension. Methodology: Parallel group study design in which 66 subjects from Hypertension OPD of Tertiary Health Care Centre were enrolled after taking their consent and Institutional Ethical approval. The subjects were randomly allocated to Control (N=33) (receiving standard treatment of care) and Experimental (N=33) (receiving Buteyko and standard treatment of care). Standard treatment of care included medication and educational videos on Hypertension, its complications and management. Buteyko Breathing Technique included supervised session of 30 minutes using a video once in a week for 4 weeks. Subjects were informed to perform these exercises at home daily. Results: The experimental group showed a significant reduction in SBP (p=0.00), DBP (p=0.00), Resting HR (p=0.00) and a significant improvement in Control Pause (p=0.00) and 6MWD (p=0.00). There was a mean reduction in SBP of 8.6 + 6.31 mmHg (95% CI, 10.84- 6.36 mmHg) and in DBP of 4.606 + 4.34 mmHg (95% CI, 6.14-3.06mmHg). Conclusion: Buteyko Breathing Technique has a positive effect on Haemodynamic parameters and functional capacity in subjects with Essential Hypertension. [ABSTRACT FROM AUTHOR]

Background: The association between cognitive decline and diabetes mellitus has been evidenced throughout recent decades. Objectives: The objective of this study was to determine the prevalence of cognitive decline in diabetics and nondiabetics in association with age, gender, level of education, risk factors, and duration of diabetes mellitus in middle-aged and elderly patients. Materials and Methods: A prospective, case-control study was conducted at a tertiary-care center between May 2014 and December 2015. Patients with diabetes (n = 150) and normal patients (n = 150) were compared. Patients were divided into groups according to age, gender, education, and duration of diabetes mellitus. The Hindi mini-mental state examination (HMMSE) was used to detect cognitive decline. Results: In diabetics with HMMSE score <27, 24 (46.1%) were aged <60 years, whereas 28 (53.9%) were aged =60 years. In diabetics with HMMSE score =27, 52 (53.1%) were aged <60 years, whereas 46 (46.9%) were aged =60 years. This finding was not statistically significant. In nondiabetics with HMMSE score <27, 13 (34.2%) nondiabetics were aged <60 years, whereas 25 (65.8%) were aged =60 years. In nondiabetics with HMMSE score =27, 61 (54.4%) were aged <60 years, whereas 51 (45.6%) were aged =60 years. This finding was statistically significant. Conclusion: Our study findings revealed no statistically significant findings in diabetics. However, specific cognitive domains such as orientation to place, concentration, and drawing displayed statistical significance for cognitive decline. [ABSTRACT FROM AUTHOR]

Objectives : The Indian Registry on Current Patient Profiles and Treatment Trends in Hypertension (Record) evaluated the current trends and outcomes related to hypertension (HTN) management at 3, 6, 12, and 24 months in India. This study highlights and evaluates the outcomes and trends noted at 24 months. Materials and methods : The detailed study methodology is provided in the earlier publication (interim analysis at 12 months). Aspects such as changes in the quality of life (QOL), percentage of patients reaching target blood pressure (BP), treatment pattern among patients with comorbid conditions, and difference in treatment patterns between public and private healthcare settings, at 24 months, were evaluated in the current study. Results : The study population included 2,000 patients (55.7% males) with a mean age of 54.45 years. Telmisartan (43.7%) and amlodipine + telmisartan (16.4%) were the most prescribed monotherapy and combination therapy among patients with newly diagnosed HTN. A significant decrease in both systolic BP (SBP) and diastolic BP (DBP) was noted in the overall patient population at 24 months ( p < 0.001). The mean change in SBP and DBP was slightly higher at 24 months compared to 12 months. This was more evident among patients on combination therapy. A significant improvement in QOL was noted at 24 months. Conclusion : Treatment strategies in HTN management are changing and are associated with effective HTN control and improvements in QOL. However, there is a further need for improved awareness regarding the optimal usage of combination therapy for better management of uncontrolled HTN. How to cite this article : Rajadhyaksha GC, Reddy H, Singh AK, et al. The Indian REgistry on Current Patient PrOfiles and TReatment TrenDs in Hypertension (RECORD): Final Outcomes of the Real-World Observational Study. J Assoc Physicians India 2023;71(11):43-49., (© Journal of the Association of Physicians of India 2023.)

Recent studies have demonstrated the role of nandrolone decanoate (ND) in reversal of wasting associated with HIV infection. However, such studies in Indian scenario are lacking. Hence, the present study was planned with an objective to assess the effect of ND in patients of HIV-associated wasting in Indian subjects. The study was a prospective, randomised, multicentric, open labelled and comparative one in male HIV-infected subjects, aged between 18 and 65 years with involuntary weight loss of 10% over 12 months or 7.5% over 6 months or 5% over 3 months. The subjects were on stable antiretroviral therapy including at least 2 agents with CD, count > or =50 cells/microl. In the treatment group, ND (150 mg) intramuscularly every 2 weeks for 12 weeks was administered according to randomisation. Fat-free mass (FFM), body weight, CD4 count, and patient perception of treatment were the main outcomes measures. Of the 73 enrolled subjects, 69 completed study duration of 12 weeks. Compared to baseline, ND treated group demonstrated significant increase in FFM (0.49 +/- 1.26 kg; p < 0.01) and body weight (1.31 +/- 1.87 kg; p < 0.01) and control group demonstrated significant increase in body weight (0.99 +/- 1.48 kg; p < 0.01) at the end of treatment period. Compared to control group, patient perception of benefit and subjective recovery of symptoms was significantly (p < .0001) greater in the ND group. None of the patients had any clinically significant deterioration of biochemical as well as laboratory safety parameters. Nandrolone was well tolerated with few reported adverse events of mild and non-serious in nature. Nandrolone improved patient perception of benefit and subjective recovery of symptoms in wasting associated HIV. Nandrolone therapy may prove to be effective and safe in reversing wasting associated with Indian HIV patients on antiretroviral therapy (ART) and nutritional replacement.

Postprandial hyperglycaemia and spikes have deleterious effects on Insulin secretion and sensitivity. The present study was undertaken to evaluate the efficacy, safety and tolerability of miglitol 50 mg three times daily for 12 weeks in 129 patients with type 2 diabetes mellitus, inadequately managed with diet and exercise therapy alone for 3 months after obtaining their written informed consent. The primary efficacy variables were per cent change from baseline at week 12 in fasting and postprandial plasma glucose concentrations and glycosylated haemoglobin (HbA(1C)) levels. After treatment at the end of 12 weeks mean reduction in fasting plasma glucose levels was 35.7% and 44.33% in postprandial plasma glucose levels while the mean HbA(1C) was significantly reduced by 0.88% (p<0.05). Total cholesterol, HDL, LDL and TC/HDL ratio did not showed any significant change but a non-significant reduction in triglyceride levels was observed in some patients. The mean body mass index was reduced non-significantly by 8% from baseline values. A total 19.5% patients treated with miglitol reported adverse events like flatulence, abdominal pain, nausea/vomiting, diarrhoea and dyspepsia. Only one patient reported hypoglycaemia. The results of the present study indicate that miglitol reduces fasting and postprandial plasma glucose levels, Improving glycaemic control, which is reflected in a reduced HbA(1C) level in patients with type 2 diabetes mellitus. It could be a useful first-line therapy in patients with type 2 diabetes mellitus inadequately controlled by diet alone and as adjuvant therapy in patients who are inadequately controlled with diet and sulfonylureas.

The objective of the study was to assess the efficacy, safety and tolerability of a fixed dose combination of telmisartan 40 mg and hydrochlorothiazide 12.5 mg in adult Indian patients with mild to moderate hypertension. A prospective, multicentric, open-label, non-comparative, phase IV study was conducted. A total of 353 patients of either sex, between 18- 65 years of age with supine blood pressure (BP) levels of systolic BP (SBP) of 140-200 mmHg and diastolic BP (DBP) of 95-114 mmHg were included. After a placebo run-in period of 2 weeks, each patient received a fixed dose combination of telmisartan/hydrochlorothiazide (40mg/12.5mg) once daily, for 8 weeks. Supine BP was assessed at the end of every 2 weeks. Tolerability and safety were assessed by physical examination, laboratory parameters and evaluation of adverse events. A total of 339 patients completed the study with 14 drop-out cases because of loss to follow-up. There was a significant fall (p<0.05) in both the SBP and DBP starting from the second week as compared to the baseline. Mean SBP had a significant reduction of 23.55 mmHg (15.0%) and 27.79 mmHg (18%) at the end of 6th and 8th week respectively, compared to baseline values. Mean DBP had also had a significant reduction of 12.51 mmHg (12.6%) and 15.17 mmHg (15.3%) at the end of 6th and 8th week respectively, compared to baseline values. This combination was well tolerated with only 3.9% of the total cases reporting mild adverse events like fatigue, dizziness, nausea, diarrhoea etc. The laboratory values were within normal limits. Fixed dose combination of telmisartan/hydrochlorothiazide (40 mg/12.5 mg) once daily has a significant therapeutic effect and a good tolerability profile in adult Indian patients with mild to moderate hypertension.